Project Summary: The type 2 diabetes epidemic is a global health issue that is especially severe in the United States Associated Pacific Islands (USAPI) including the Commonwealth of the Northern Mariana Islands (CNMI).1 The prevalence rate of diabetes in the CNMI is 34%, which is four times higher than the US diabetes rate of 8%.2-4 Pacific Islanders living in the U.S also face greater burden of diabetes as compared to the general population.5-7 According to the Office of Minority Health, Native Hawaiians and Other Pacific Islanders have a higher rates of diabetes (20.6%) than Whites (6.4%).8 Although there are diabetes prevention and management programs in Hawai'i and the Pacific, success is limited due in part to the lack of tailoring for the Pacific audience.9,10 In spite of numerous recommendations11-18 to incorporate Pacific cultural constructs (including spirituality) into health interventions, to our knowledge, there are no studies in the CNMI or the Pacific that examines the integration of these cultural constructs into diabetes prevention and management. To address the need for research in the Pacific, an innovative partnership was formed between the Pacific Chronic Disease Coalition and faith community coalitions from Hawai'i and the Pacific. This new partnership, also known as Faith in Action Research Alliance (FARA) selected the University of Iowa to be their scientific partner and the CNMI and Hawai'i to be the two sites for this research project. This research will also benefit from experts from the faith and medical community. Our aim is to use the Social Cognitive Theory, Grounded Theory and Community Based Participatory Research (CBPR) processes to assist in the development of an innovative culturally based conceptual framework that explains relationships between constructs such as culture, religion, family, and diabetes prevention and control. This framework will assist in the design of future diabetes prevention and control interventions. PUBLIC HEALTH RELEVANCE: Project Narrative Type 2 diabetes disproportionally affects Pacific Islanders. The Faith in Action Research Alliance's aim to reduce the burden of diabetes among Pacific Islanders in Hawaii and the Pacific by conducting Community Based Participatory Research that integrates cultural construct (including region and spirituality) to inform future diabetes prevention and management interventions.